In Vitro Fertilization (IVF)

In Vitro Fertilization (IVF) is the most advanced procedure currently available to help couples struggling with infertility to achieve pregnancy. It means that egg and sperm are combined outside of the body, and embryos develop in a culture dish under optimal conditions. Medical science and IVF technology have advanced enormously since the late 1970’s when the first IVF pregnancies were achieved.

Who Should Consider IVF?

IVF is the most effective treatment for women and couples who suffer from infertility related to blocked fallopian tubes, endometriosis, pelvic scarring from previous surgery or infections, or low sperm counts. It is also very successful for women and couples who have unexplained infertility and who have not successfully conceived with more conservative forms of treatment such as Ovulation Induction and Intrauterine Insemination (IUI).

What is Involved in an IVF Cycle?

1Stage 1: Ovarian Stimulation

The first phase of IVF is Controlled Ovarian Hyperstimulation (COH). We use various combinations of injectable hormones including Gonal-F®, Follistim®, Bravelle®, and Menopur®, to stimulate a woman’s ovaries into preparing more than one egg.

Every egg develops within a sac of fluid called a follicle, and hormonal stimulation of the ovaries results in the development of several follicles. We carefully monitor this process, using blood tests to measure hormone levels and pelvic ultrasound examinations of the ovaries to assess the maturation of the growing follicle, and then adjust the dosage of medications as necessary.

Whereas IUI only involves a few eggs released for potential fertilization, IVF involves the production of multiple eggs and is therefore considered to be a more aggressive approach with better odds for successful conception.

2Stage 2: The Egg Retrieval Phase

When the ovarian follicles are large, indicating that the eggs contained are near optimal maturity, you will be instructed to administer an injection of Human Chorionic Gonadotropin (hCG). This “trigger shot” activates the final maturation of the eggs.

Egg retrieval occurs approximately 36 hours after the hCG injection. Using ultrasound guidance to help us identify the follicles containing the eggs, the doctor inserts a thin needle through the vaginal wall and guides it into the follicles, gently removing the mature egg.

Egg retrieval is done here at the Fertility Institute in our procedure room, usually with the patient under conscious sedation or light anesthesia. The entire procedure takes approximately 15 minutes. The patient does not feel or remember anything, and is able to breathe comfortably on her own during the procedure.

3Stage 3: Fertilization and Embryo Culture

The eggs are then placed in a special culture medium in the lab. Several hours later, the eggs are inseminated or injected (ICSI) with sperm. Successful fertilization of the eggs can be seen under a high-powered microscope the next day. In vitro culture of the early embryos is performed under continuous and carefully controlled conditions in the Fertility Institute’s embryology laboratory.

4Stage 4: Embryo Transfer

After the early embryos have developed In vitro for several days in one of our state-of-the-art incubators in the laboratory, they are ready to be placed into the woman’s uterus in a procedure called the embryo transfer.

The embryo transfer itself is painless and does not involve any needles or sharp instruments. The embryo or embryos are loaded into a long, thin, soft tube called a catheter which is then threaded through the natural opening of the woman’s cervix and guided to a spot near the top of her uterus, all monitored via ultrasound. Once the soft tip of the catheter reaches its intended destination, the embryo is gently deposited in the appropriate location.

The embryo transfer procedure is performed here at the Fertility Institute in our procedure room and takes approximately 10 minutes.

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection (ICSI) is performed as a part of an IVF cycle to assist with fertilization of eggs. After the eggs have been aspirated as part of the egg retrieval process, they are taken to the embryology laboratory where they are placed in a special culture medium. Several hours later, using specialized manipulation tools, a single sperm is selected by our highly skilled embryologists using a high-powered microscope. The egg is then stabilized with a pipette and an ultra-thin ICSI needle, which contains the sperm, advances through the outer shell of the egg and membrane and the sperm is injected into the inner part of the egg.

ICSI is recommended for couples with male fertility issues such as low sperm count, low sperm morphology or motility, or those who have previously had a vasectomy or had an unsuccessful vasectomy reversal. It is also indicated for couples who have experienced poor fertilization rates with standard IVF, and for those who elect to have pre-implantation genetic testing completed.

Vitrification

At the Fertility Institute of NJ & NY we exclusively use vitrification, which is a state-of-the-art ultra-rapid freezing process. Embryos frozen using vitrification technique have high rates of survival and implantation.

Pregnancy Testing

We will administer your post-IVF pregnancy test 7 to 10 days after the embryo transfer. This is the earliest we can confirm that a pregnancy has started to develop. We know that anticipation and hope run high during this waiting period, and we do everything in our power to support patients in the interim.

If your pregnancy test indicates the IVF procedure was successful, your physician will monitor the subsequent early pregnancy development with blood tests and ultrasound examinations to help ensure the best possible outcome.